Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Lumbar Compression Fracture Differential Diagnoses

  • Author: Andrew L Sherman, MD, MS; Chief Editor: Stephen Kishner, MD, MHA  more...
 
Updated: May 23, 2016
 
 

Diagnostic Considerations

These include the following:

  • Spinal malignancy resulting in fracture
  • Renal failure
  • Hemangioma of vertebral body
  • Osteomyelitis
  • Pott disease

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Andrew L Sherman, MD, MS Associate Professor of Clinical Rehabilitation Medicine, Vice Chairman, Chief of Spine and Musculoskeletal Services, Program Director, SCI Fellowship and PMR Residency Programs, Department of Rehabilitation Medicine, University of Miami, Leonard A Miller School of Medicine

Andrew L Sherman, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, Association of Academic Physiatrists

Disclosure: Nothing to disclose.

Coauthor(s)

Nizam Razack, MD, FACS Assistant Professor of Neurological Surgery, Orthopedics, and Rehabilitation, University of Miami; Neurosurgeon, Spine and Brain Neurosurgery Center; Chairman, Department of Neurosurgery, Orlando Regional Medical Center

Nizam Razack, MD, FACS is a member of the following medical societies: American Association of Neurological Surgeons, American College of Surgeons, Florida Medical Association, Society for Neuro-Oncology, Congress of Neurological Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Patrick M Foye, MD Director of Coccyx Pain Center, Professor and Interim Chair of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School; Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, University Hospital

Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, International Spine Intervention Society, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists

Disclosure: Nothing to disclose.

Chief Editor

Stephen Kishner, MD, MHA Professor of Clinical Medicine, Physical Medicine and Rehabilitation Residency Program Director, Louisiana State University School of Medicine in New Orleans

Stephen Kishner, MD, MHA is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Curtis W Slipman, MD Director, University of Pennsylvania Spine Center; Associate Professor, Department of Physical Medicine and Rehabilitation, University of Pennsylvania Medical Center

Curtis W Slipman, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, International Association for the Study of Pain, North American Spine Society

Disclosure: Nothing to disclose.

References
  1. Suh TT, Lyles KW. Osteoporosis considerations in the frail elderly. Curr Opin Rheumatol. 2003 Jul. 15(4):481-6. [Medline].

  2. Sundaresan N, Rosen G, Boriani S. Primary malignant tumors of the spine. Orthop Clin North Am. 2009 Jan. 40(1):21-36, v. [Medline].

  3. Fast Facts on Osteoporosis. National Osteoporosis Foundation. Available at http://www.nof.org/osteoporosis/diseasefacts.htm. Accessed: May 26. 2009.

  4. Imai N, Endo N, Hoshino T, et al. Mortality after hip fracture with vertebral compression fracture is poor. J Bone Miner Metab. 2014 Dec 14. [Medline].

  5. Gibson JE, Pilgram TK, Gilula LA. Response of nonmidline pain to percutaneous vertebroplasty. AJR Am J Roentgenol. 2006 Oct. 187(4):869-72. [Medline]. [Full Text].

  6. Karaca L, Yuceler Z, Kantarci M, et al. The feasibility of dual-energy CT in differentiation of vertebral compression fractures. Br J Radiol. 2016. 89 (1057):20150300. [Medline].

  7. American College of Radiology. ACR Appropriateness Criteria® osteoporosis and bone mineral density. National Guideline Clearinghouse. Available at http://guideline.gov/summary/summary.aspx?doc_id=11559. Accessed: May 26, 2009.

  8. Bredella MA, Essary B, Torriani M, Ouellette HA, Palmer WE. Use of FDG-PET in differentiating benign from malignant compression fractures. Skeletal Radiol. 2008 May. 37(5):405-13. [Medline]. [Full Text].

  9. Piazzolla A, Solarino G, Lamartina C, et al. Vertebral Bone Marrow Edema (VBME) in Conservatively Treated Acute Vertebral Compression Fractures (VCFs): Evolution and Clinical Correlations. Spine (Phila Pa 1976). 2015 Jul 15. 40 (14):E842-8. [Medline].

  10. Hsieh PC, Koski TR, Sciubba DM, Moller DJ, O'Shaughnessy BA, Li KW, et al. Maximizing the potential of minimally invasive spine surgery in complex spinal disorders. Neurosurg Focus. 2008. 25(2):E19. [Medline].

  11. Selznick LA, Shamji MF, Isaacs RE. Minimally invasive interbody fusion for revision lumbar surgery: technical feasibility and safety. J Spinal Disord Tech. 2009 May. 22(3):207-13. [Medline].

  12. Castellon AT, Meves R, Avanzi O. Intraoperative neurophysiologic spinal cord monitoring in thoracolumbar burst fractures. Spine (Phila Pa 1976). 2009 Nov 15. 34(24):2662-8. [Medline].

  13. Dalbayrak S, Onen MR, Yilmaz M, et al. Clinical and radiographic results of balloon kyphoplasty for treatment of vertebral body metastases and multiple myelomas. J Clin Neurosci. 2010 Feb. 17(2):219-24. [Medline].

  14. Layton KF, Thielen KR, Koch CA, Luetmer PH, Lane JI, Wald JT, et al. Vertebroplasty, first 1000 levels of a single center: evaluation of the outcomes and complications. AJNR Am J Neuroradiol. 2007 Apr. 28(4):683-9. [Medline]. [Full Text].

  15. Muijs SP, Nieuwenhuijse MJ, Van Erkel AR, Dijkstra PD. Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures: evaluation after 36 months. J Bone Joint Surg Br. 2009 Mar. 91(3):379-84. [Medline].

  16. Rapan S, Jovanovic S, Gulan G. Vertebroplasty for vertebral compression fracture. Coll Antropol. 2009 Sep. 33(3):911-4. [Medline].

  17. Kim BS, Hum B, Park JC, et al. Retrospective review of procedural parameters and outcomes of percutaneous vertebroplasty in 673 patients. Interv Neuroradiol. 2014 Oct 31. 20(5):564-75. [Medline]. [Full Text].

  18. Han S, Park HS, Pee YH, et al. The clinical characteristics of lower lumbar osteoporotic compression fractures treated by percutaneous vertebroplasty: a comparative analysis of 120 cases. Korean J Spine. 2013 Dec. 10(4):221-6. [Medline]. [Full Text].

  19. Wardlaw D, Cummings SR, Van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet. 2009 Mar 21. 373(9668):1016-24. [Medline].

  20. Taylor RS, Fritzell P, Taylor RJ. Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J. 2007 Aug. 16(8):1085-100. [Medline]. [Full Text].

  21. Lo YP, Chen WJ, Chen LH, Lai PL. New vertebral fracture after vertebroplasty. J Trauma. 2008 Dec. 65(6):1439-45. [Medline].

  22. Trout AT, Kallmes DF, Kaufmann TJ. New fractures after vertebroplasty: adjacent fractures occur significantly sooner. AJNR Am J Neuroradiol. 2006 Jan. 27(1):217-23. [Medline].

  23. Ohtori S, Yamashita M, Inoue G, et al. L2 spinal nerve-block effects on acute low back pain from osteoporotic vertebral fracture. J Pain. 2009 Aug. 10(8):870-5. [Medline].

  24. Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, et al. Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Arch Intern Med. 2009 Mar 23. 169(6):551-61. [Medline].

  25. O'Daly BJ, Morris SF, O'Rourke SK. Long-term functional outcome in pyogenic spinal infection. Spine. 2008 Apr 15. 33(8):E246-53. [Medline].

  26. Luzzati R, Giacomazzi D, Danzi MC, Tacconi L, Concia E, Vento S. Diagnosis, management and outcome of clinically- suspected spinal infection. J Infect. 2009 Apr. 58(4):259-65. [Medline].

  27. Hirakawa M, Kobayashi N, Ishiyama M, Fuwa S, Saida Y, Honda H, et al. Radiological findings as favorable predictors of pain relief in patients with osteoporotic compression fractures after percutaneous vertebroplasty: a retrospective study of 156 cases. Jpn J Radiol. 2012 Feb 28. [Medline].

  28. Benzel EC, Ball PA. Management of low lumbar fractures by dorsal decompression, fusion, and lumbosacral laminar distraction fixation. J Neurosurg. 2000 Apr. 92(2 Suppl):142-8. [Medline].

  29. Crandall D, Slaughter D, Hankins PJ, et al. Acute versus chronic vertebral compression fractures treated with kyphoplasty: early results. Spine J. 2004 Jul-Aug. 4(4):418-24.

  30. Dunnagan SA, Knox MF, Deaton CW. Osteoporotic compression fracture with persistent pain. Treatment with percutaneous vertebroplasty. J Ark Med Soc. 1999 Dec. 96(7):258-9. [Medline].

  31. Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine. 2001 Jul 15. 26(14):1511-5. [Medline].

  32. Harrington KD. Vertebral compression fractures: differentiation between benign and malignant causes. Iowa Orthop J. 1993. 13:85-96.

  33. Hu SS, Capen DA, Rimoldi RL, Zigler JE. The effect of surgical decompression on neurologic outcome after lumbar fractures. Clin Orthop. 1993 Mar. (288):166-73. [Medline].

  34. Kai MC, Anderson M, Lau EM. Exercise interventions: defusing the world''s osteoporosis time bomb. Bull World Health Organ. 2003. 81(11):827-30.

  35. Shaffrey CI, Shaffrey ME, Whitehill R, Nockels RP. Surgical treatment of thoracolumbar fractures. Neurosurg Clin N Am. 1997 Oct. 8(4):519-40. [Medline].

  36. Sinaki M, Wollan PC, Scott RW, Gelczer RK. Can strong back extensors prevent vertebral fractures in women with osteoporosis?. Mayo Clin Proc. 1996 Oct. 71(10):951-6. [Medline].

  37. Siris ES, Chen YT, Abbott TA, et al. Bone mineral density thresholds for pharmacological intervention to prevent fractures. Arch Intern Med. 2004 May 24. 164(10):1108-12.

  38. Teng MM, Cheng H, Ho DM, Chang CY. Intraspinal leakage of bone cement after vertebroplasty: a report of 3 cases. AJNR Am J Neuroradiol. 2006 Jan. 27(1):224-9. [Medline].

  39. Viljakainen HT, Natri AM, Karkkainen M, et al. A positive dose-response effect of vitamin D supplementation on site-specific bone mineral augmentation in adolescent girls: a double-blinded randomized placebo-controlled 1-year intervention. J Bone Miner Res. 2006 Jun. 21(6):836-44.

  40. Von Feldt JM. Managing osteoporotic fractures: minimizing pain and disability. Rev Rhum Engl Ed. 1997 Jun 30. 64(6 Suppl):78S-80S. [Medline].

Previous
Next
 
Anteroposterior and lateral radiographs of an L1 osteoporotic wedge compression fracture.
Fluoroscopic view of a kyphoplasty procedure.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.